Pitkin County officials: social distancing working, slow rollout to return coming next week

Five people begin to file inside Aspen’s City Market after waiting in line at the door on Thursday, March 26, 2020. City Market is limiting the number of people allowed in the store at one time, as well as allowing senior citizens preferential treatment to enter the store first. Kelsey Brunner/The Aspen Times

When it comes to the restrictive public health orders that have dominated life during the past month, the long-term message from public health officials Thursday was get used to it: Nothing is going back to the way it was for a long time.

“We’re going to need to continue physical distancing,” Pitkin County Public Health Director Karen Koenemann told members of the county Board of Health. “I think that will be with us for the long haul.”

But neither are we destined to indefinitely experience life by virtual reality from within the walls of our homes, she said. In fact, while the gradual loosening of public health orders will certainly lead to spikes in COVID-19 cases, unwinding the public health orders is exactly what we must do, said Dr. Kimberly Levin, the county’s medical officer.

“We need to move ahead and do this,” said Levin, also an attending physician at Aspen Valley Hospital. “We can’t stay where we are.”

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The ultimate goal, of course, “is opening everything up,” she said.

“It can happen, it will happen,” Levin said. “It needs to be done in a very controlled manner.”

The good news is that social distancing tactics meant to prevent the rapid spread of COVID-19 in Pitkin County appear to have worked, said Levin and Koenemann.

“I think we flattened the curve in Pitkin County,” Levin said.

Pitkin County has achieved at least a 70% reduction in social contacts since the first stay-at-home order March 23, which earned the county an “A” grade from a data collection site that monitored cellphone movement in 3,000 counties across the country, Koenemann said.

Pitkin County was one of the top counties monitored in terms of people staying put, and even was rated No. 1 more than once, she said.

“There was a drastic decline in people moving around,” Koenemann said. “I just want to say kudos to the community (for that).”

That compliance bought public officials time to prepare for possible future surges of COVID-19 patients by developing a “robust” testing strategy and to begin building a team that will become important when community testing, isolation and contact tracing of future coronavirus patients is the norm, she said.

Levin also praised residents for complying with the stay-at-home order, calling it a gift to hospital workers who haven’t yet had to deal with a surge of patients. The most COVID-19 patients the hospital has seen was eight March 13, the day of Pitkin County’s first public health order, she said.

“It has stayed within a manageable volume,” Levin said.

The time the public health order bought also allowed the hospital to stock up on supplies and develop a regional strategy with neighboring counties and hospitals, which includes plans for how to handle a situation that includes Denver hospitals refusing to accept more intensive care patients, Levin said.

“You’ve given us time to create this capacity,” she said.

The gradual step-down of public health order restrictions — which will begin next week with the opening of construction sites and a few other businesses — will lead to spikes in local COVID-19 cases, Levin said. But the step-downs are designed not to overwhelm the local health care system while gradually decreasing the number of residents susceptible to the virus, Koenemann said.

The ramifications of each step will likely take about two weeks to manifest, at which time officials will know whether they can handle the surge in cases or whether the order might need to be dialed back again, they said. Hospital data will be key to determining the severity of cases during each step, Levin said.

Examples of gradual steps include increasing the size of groups allowed to socialize from five to 10, and opening retail stores and restaurants, though social distancing will continue to be a factor, Koenemann said.

In order for the strategy to succeed, however, public health officials must first stabilize transmission — meaning a decrease in cases for at least 14 days — then implement stringent protocols that require community testing to identify who currently has the virus, isolating those patients, tracing all of their contacts and isolating anyone they might have infected, Koenemann said.

Effective contact tracing requires one full-time investigator for every 1,000 residents, meaning that Pitkin County will need 18 people to get the job done, she said. Local officials are looking to the state for assistance with that, though they have hired some personnel already, Koenemann said.

Testing capacity — a problem across the country — also must be increased, they said.

Pitkin County will take the first step toward community testing Friday, when officials begin a pilot program to determine the effectiveness of 1,000 COVID-19 tests they received last week, according to a Thursday news release. The tests measure antibodies in the blood and will provide information about the depth of the virus infection in the community, officials have said.

Sixteen people who have previously been tested for COVID-19 have been chosen as a test group, the release states. The tests will be conducted at the Aspen Village Fire Station.

Further details about who will be tested and when have not yet been released by public health officials.

“Pitkin County epidemiologists will be selecting candidates for further testing from the county’s residents, as well as workers from essential businesses within Pitkin County who may not reside here,” according to Thursday’s news release.

Officials have said a plan for the testing was to be finalized by Friday.

Meanwhile, Pitkin County reported 51 positive COVID-19 cases as of Wednesday, according to the Colorado Department of Health and Environment. The state reported 8,675 positive cases as of Wednesday afternoon, with 374 deaths.

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